6 HEALTH & SCIENCE S U N D AY, M AY 10 , 2 015 T H E J E R U S A L E M P O S T

Learning from fish to develop new materialsBulletproof uniforms and space suits impervious to micro-meteorites are two of the potential applications for new materials developed at the Technion-Israel Institute of Technology’s faculty of aerospace engineering.

These are two of the possible Technion applications for new complex material, according to an article in a technology journal. These materials were developed by Assistant Prof. Stephan Rudykh, head of mechanics at the soft materials lab.

“Flexibility and strength are considered as usually com-peting properties; as one increases the other decreases. In general, this is true, but in my research I am trying to create materials that will be both flexible and strong (with respect to their penetration resistance),” Rudykh said.

Starting out as a theorist, Rudykh started to experiment with various formulas after being exposed to the world of 3D printing during his post-doctoral work at the Massa-chusetts Institute of Technology. He specializes in creating complex soft materials.

“Suddenly I could make the materials that I was design-ing,” he said, “and then check if their properties match my theoretical projections. Now, too, with these materials, which are flexible and relatively durable against pene-tration, I can run trials on the models I print.” Rudykh’s research is a joint effort between the Technion and MIT.

He joined the Technion’s faculty as an assistant professor straight from his post-doctoral studies. His research has already been published in leading journals such as Physical Review Letters, and his most recent article was published in Soft Matter.

The inspiration for Rudykh’s development of the new

strong and flexible materials comes from fish.“They are flexible creatures but are protected by hard

scales. Their “secret” is the combination of the scales and the soft tissue beneath them, and that is what I tried to mimic here. The materials that I am designing are also made of two layers – one soft (the body) and the other (scales) constitutes the ‘armor.’ These two components provide the combined property of ‘protecto-flexibility’ that we want.”

When asked about possible applications, Rudykh is very cautious.

“My job is not to develop applications but rather to design the material, and my focus at present is the opti-mization of the material. If, for example, we were talking about army uniforms or a space suit against micro-meteor-ites, then there are areas such as the chest that need hardly any flexibility and other areas such as the elbow, where flexibility is essential.”

Rudykh stressed that it’s extremely challenging to com-pletely counteract the inverse relationship between flexibil-ity and strength, but said that it is possible to play with the trade-off between them.

“I have managed to increase the penetration resistance by a factor of 40, while reducing flexibility by only a factor of five, and that opens a great many options. Concerning army uniforms or space suits, the idea is to create a tai-lor-made fabric based on the soldier’s body type and of course the conditions he will be facing. For example, we can think about protection of spacemen against space radiation by incorporating protective materials into the microstructure of the flexible composites.”

FORGET ASTROLOGY AND STOP BLAMING THE MOON

“It must be a full moon” is a common refrain when things appear more hectic than usual. The moon is blamed even when things get crazy at hospital emergency rooms or delivery wards.

“Some nurses ascribe the apparent chaos to the moon, but dozens of studies show that the belief is unfounded,” said planetary astronomy Prof. Jean-Luc Margot of the University of California at Los Angeles. Of course, the moon does not influence the timing of human births or hospital admissions, according to Margot’s new research that confirms what scientists have known for decades. The study illustrates how intel-ligent and otherwise rea-sonable people develop strong beliefs that, to put it politely, are not aligned with reality.

The absence of a lunar influence on human affairs has been demonstrated in the areas of automobile accidents, hospital admissions, surgery outcomes, cancer survival rates, menstruation, births, birth complications, depres-sion, violent behavior and even criminal activity, Margot wrote in the journal Nursing Research.

Even though a 40-year-old UCLA study demonstrated that the timing of births does not correlate in any way with the lunar cycle, the belief in a lunar effect has persisted. A 2004 study in a nursing journal, for example, suggested that the full moon influenced the number of hospital

admissions in a medical unit in Barcelona.But Margot identified multiple flaws in the data collection

and analysis of the 2004 research. By re-analyzing the data, he showed that the number of admissions was unrelated to the lunar cycle. “The moon is innocent,” Margot said.

So why do the erroneous beliefs live on in spite of the evidence? Margot cited what scientists refer to as the “confirmation bias” – people’s tendency to interpret infor-mation in a way that confirms their beliefs and ignore data that contradict them. When life is hectic on the day of a full moon, many people remember the association because it confirms their belief. But hectic days that do not corre-spond with a full moon are promptly ignored and forgot-ten because they do not reinforce the belief. Margot said

the societal costs of flawed beliefs can be enormous. In just one current exam-ple, the recent measles out-break appears to have been triggered by parents’ ques-

tionable beliefs about the safety of the measles vaccine.“Vaccines are widely and correctly regarded as one of the

greatest public health achievements, yet vaccine-prevent-able diseases are killing people because of beliefs that are out of step with scientific facts,” Margot said.

A willingness to engage in evidence-based reasoning and admit that one’s beliefs may be incorrect will produce a more accurate view of the world and result in better decision-making, Margot said. “Perhaps we can start by correcting our delusions about the moon, and work from there,” he concluded.

NEW WORLDS• By JUDY SIEGEL-ITZKOVICH

Treating the tongue-tiedStuttering affects five percent of the world’s population

at some time in their lives and disappears in most young children. But while treatable, it is incurable

and a lifelong condition in adults. Judy Siegel-Itzkovich reports

What did Marilyn Monroe, Demosthenes, Winston Churchill, Jimmy Stew-art, King George VI, Elvis Presley, Lewis Carroll,

Nicole Kidman, Joe Biden and James Earl Jones have in common? Some might add to this list of sometime or long-time stut-terers the great Jewish prophet and deliv-erer of Israel – Moses. But others argue he just spoke slowly and deliberately, was not fluent in either Hebrew or Egyptian, had another speech impediment from putting a hot coal into his mouth as a child or was just humble.

Jones is quoted as saying something that all would have probably agreed with: “One of the hardest things in life is having words in your heart that you can’t utter.”

Stammering or stuttering is a speech disor-der in which the flow of speech is disrupted by involuntary repetitions and prolonga-tions of sounds, syllables, words or phrases and involuntary silent pauses or blocks in which the person who stutters is unable to produce sounds. It affects some one percent

of all human beings at any given moment, but about 5% of all ethnic and racial back-grounds will have it at one time in their lives. An estimated 70 million people around the world are stutterers.

The speech problem is much more com-mon in boys than in girls – four or five times more common, as in autism – and when stut-tering strikes girls, it is much more likely to disappear by itself. About 75% of preschool-ers who begin to stutter will eventually stop. Many children who “recover” from stutter-ing do so within months of the onset.

The condition most commonly involves involuntary repetition of sounds, but it may also involve abnormal hesitation before speech known as “blocks” and the prolonga-tion of certain sounds, usually vowels. Stut-tering is generally not a problem with the actual physical production of speech sounds or putting thoughts into words. The term encompasses a wide range of severity, includ-ing impediments that are barely perceptible and others that are severe and make it very difficult to communicate.

Following World Voice Day in April, The

Jerusalem Post interviewed two speech and language pathologists (SLPs) – one of them a specialist who spends most of her time diagnosing and treating stammerers. Dr. Esti Makai, director of the hearing and speech institute at Tel Aviv Sourasky Medical Center, also lectures in the field of clinical commu-nications at Tel Aviv University’s School of Health Professions.

“I originally wanted to be a physician, but when I was not accepted, I decided to go in this field, which has lots of medicine and focuses on treatment. Today, the vast num-ber of speech and language pathologists are women and must undergo examinations that when passed entitles them to an official cer-tificate from the Health Ministry,” she said.

NAAMA SHACHAR, chairman of the Israel Speech, Hearing and Language Association (the professional organization representing the country’s certified specialists) noted that every certified graduate of schools for SLPs have the right to work in any related field. These range from the treatment of stammer-ing to lisps, hearing disabilities and voice

problems, as there are no sub-specialties in the field. There are hundreds of specialists who treat stammerers, said Shachar.

However, her professional organization is aware of “many” people without ministry authorization who do not claim to be spe-cialists but nevertheless offer treatment.

“They are sometimes cheaper, but not always. They may not work in public institu-tions like hospitals and health funds, which don’t accept anyone without a certificate. But they offer services from private offices or their own homes,” she added with con-sternation.

Asked by the Post to comment, the Health Ministry confirmed that if someone did not claim to be an SLP but offered treatment for stuttering, she (or he) could legally do so.

“A 2008 law prohibits someone from pre-senting himself as a clinical communications specialist if he does not have a certificate from the Health Ministry,” according to the ministry spokeswoman.

If anyone can put up a sign offering “treat-ment for stuttering,” one wonders why others would bother to study the field as academics and take qualifying tests for a ministry certificate. But at the same time, the ministry recommended that the public go to

speech therapists with ministry certificates to get treatment for hearing or speech.

MAKAI SAID she didn’t intentionally go into the field to focus on stammering.

“Some young people go right into it, while others avoid it. You need to have a great deal of patience to go into this field, and you can’t promise a cure.”

Aside from neurophysiology and environ-ment, there is also probably a genetic influ-ence, the Sourasky expert said. The condi-tion tends to run in families and may be shared in identical twins, but not necessarily. Yet researchers believe there is not a single gene involved and that environmental influ-ences must be present to cause stuttering, not genes alone. It’s rare for adult sufferers of stroke, physical trauma or a brain tumor to start stammering, but when it does occur, the condition is very hard to treat. For some peo-ple who stutter, congenital factors such as cerebral palsy, physical trauma at or around birth and learning disabilities may play a role. In others, there could be added impact from stressful situations such as the birth of a sibling, moving to a new home or even a sudden growth in linguistic ability.

While nervousness and stress do not cause stuttering, the condition can have a serious effect on a person’s functioning and emo-tional condition. The stutterer may be afraid to enunciate specific vowels or consonants, and of stammering in social situations, and may isolate himself to avoid verbal contact with others. He may even rearrange words in a sentence or substitute words for those he has difficulty pronouncing.

The condition is variable, and sufferers may stutter one day and be free of it on the next. Interestingly, stutterers don’t have a prob-lem when they sing or speak to themselves, and it is less apparent when they speak in a

language that is not their mother tongue, apparently because they do this more slowly than in their regular language, Makai said. Stuttering is also less common in deaf and those who are hard of hearing. Some people stammer more when they speak publicly to a large audience and less when talking on the phone, but for others, it is the opposite – all depending on whether or not the stammerer is self-conscious.

They may not only repeat syllables but also add unnecessary “ums” or “uhs,” go back and correct what they originally said, clear their throats or smack their lips.

BUT AS shown by the list of famous stutter-ers, the defect doesn’t have to hold anyone back. Even Israel Defense Forces soldiers may stutter. They can’t easily be commanding officers, who need to quickly shout out orders, but can serve in many other capaci-ties. At least today they don’t have to speak with pebbles in their mouths or shout at waves at the beach like the Greek orator Demosthenes, suggested Makai.

Very young children who stutter usually don’t suffer from their impediment, as every-one at this age has some problems when they start to speak. But in kindergarten or even pre-kindergarten, their peers identify those who are different and may make fun of them. At older ages, stutterers may be bullied by their peers. Their teachers should be taught at least to identify speech problems and to refer parents to help. Health funds pay for counseling sessions by specialists, but often the treatment period is not long enough, and the queue can be months long unless fami-lies decide to go to private clinics, said Makai.

In the periphery of the country, the queues are longer, and families tend to be less able to pay for private treatment.

“We advise parents on how to help chil-dren who stutter. From about age four, a child will feel he is stuck and can’t say every-thing he wants, but he is not ashamed of it,” she said.

Most treatment programs for stutters are behavioral. They are designed to teach the person specific skills or behaviors that lead to improved oral communication. SLP treat-ments focus on reducing stuttering by slow-ing down the speed of speech, regulating breathing and gradual advancement from single-syllable responses to longer words and eventually more complex sentences. (Hebrew speakers are notorious for speaking too fast or using only parts of words, she added.) Other therapies focus on relaxation, aiming to reduce the anxiety that usually results from stuttering.

Patients may be taught to speak more slow-ly by stretching out their consonants and vowels, or by using other techniques. As they improve, they can speak faster and improve their intonation and fluency.

“The health funds generally don’t give enough treatment. The condition, when it does not disappear in early childhood, is usually for life, and sufferers need mainte-nance. If it is s small child, I usually want to work with him for six months to a year. If he moves to a new school or kindergarten, the situation could get worse, so he needs to be followed up,” said Makai.

ALTHOUGH THERE has been much research abroad – and even in Israel – into stammer-ing, the US Food and Drug Administration has not approved any drug for treatment of stuttering. Eventually, said Makai, it will probably happen that stutterers take a pill to stop their stammering. Today, there are, however, medications that release muscles and reduce stress, and these may help. There are also electronic devices, such as those that aid in auditory feedback or biofeedback. There are also computer programs and work-shops, she added, some more helpful and some less.

Stuttering used to be regarded by parents as a tragedy, said Makai, “but not so much today. The calmer the family when the prob-lem is diagnosed, the bigger the chance that it will pass. Don’t be afraid of getting a diag-nosis of stammering,” she advised. “When they grow up, they find work and get mar-ried. Attitude is very important. I receive a lot of satisfaction from my profession and especially from helping stutterers.”

DR. ESTI MAKAI (Courtesy)(TNS)